Patient Protection and Affordable Care Act; Program Integrity; Exchange, Premium Stabilization Programs, and Market Standards; Amendments to the HHS Notice of Benefit and Payment Parameters for 2014

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ISBN 13 :
Total Pages : 60 pages
Book Rating : 4.:/5 (866 download)

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Book Synopsis Patient Protection and Affordable Care Act; Program Integrity; Exchange, Premium Stabilization Programs, and Market Standards; Amendments to the HHS Notice of Benefit and Payment Parameters for 2014 by : Wolters Kluwer Law & Business (Firm)

Download or read book Patient Protection and Affordable Care Act; Program Integrity; Exchange, Premium Stabilization Programs, and Market Standards; Amendments to the HHS Notice of Benefit and Payment Parameters for 2014 written by Wolters Kluwer Law & Business (Firm) and published by . This book was released on 2013 with total page 60 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Patient Protection and Affordable Care ACT - Program Integrity - Exchange, Premium Stabilization Programs, and Market Standards - Amendments to HHS (Us Department of Health and Human Services Regulation) (Hhs) (2018 Edition)

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Publisher : Createspace Independent Publishing Platform
ISBN 13 : 9781729722718
Total Pages : 138 pages
Book Rating : 4.7/5 (227 download)

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Book Synopsis Patient Protection and Affordable Care ACT - Program Integrity - Exchange, Premium Stabilization Programs, and Market Standards - Amendments to HHS (Us Department of Health and Human Services Regulation) (Hhs) (2018 Edition) by : The Law The Law Library

Download or read book Patient Protection and Affordable Care ACT - Program Integrity - Exchange, Premium Stabilization Programs, and Market Standards - Amendments to HHS (Us Department of Health and Human Services Regulation) (Hhs) (2018 Edition) written by The Law The Law Library and published by Createspace Independent Publishing Platform. This book was released on 2018-11-10 with total page 138 pages. Available in PDF, EPUB and Kindle. Book excerpt: Patient Protection and Affordable Care Act - Program Integrity - Exchange, Premium Stabilization Programs, and Market Standards - Amendments to HHS (US Department of Health and Human Services Regulation) (HHS) (2018 Edition) The Law Library presents the complete text of the Patient Protection and Affordable Care Act - Program Integrity - Exchange, Premium Stabilization Programs, and Market Standards - Amendments to HHS (US Department of Health and Human Services Regulation) (HHS) (2018 Edition). Updated as of May 29, 2018 This final rule implements provisions of the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 (collectively referred to as the Affordable Care Act). Specifically, this final rule outlines financial integrity and oversight standards with respect to Affordable Insurance Exchanges, qualified health plan (QHP) issuers in Federally-facilitated Exchanges (FFEs), and States with regard to the operation of risk adjustment and reinsurance programs. It also establishes additional standards for special enrollment periods, survey vendors that may conduct enrollee satisfaction surveys on behalf of QHP issuers, and issuer participation in an FFE, and makes certain amendments to definitions and standards related to the market reform rules. These standards, which include financial integrity provisions and protections against fraud and abuse, are consistent with Title I of the Affordable Care Act. This final rule also amends and adopts as final interim provisions set forth in the Amendments to the HHS Notice of Benefit and Payment Parameters for 2014 interim final rule, published in the Federal Register on March 11, 2013, related to risk corridors and cost-sharing reduction reconciliation. This book contains: - The complete text of the Patient Protection and Affordable Care Act - Program Integrity - Exchange, Premium Stabilization Programs, and Market Standards - Amendments to HHS (US Department of Health and Human Services Regulation) (HHS) (2018 Edition) - A table of contents with the page number of each section

Patient Protection and Affordable Care ACT - Program Integrity - Exchange, Premium Stabilization Programs, and Market Standards (Us Centers for Medicare and Medicaid Services Regulation) (Cms) (2018 Edition)

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Publisher : Createspace Independent Publishing Platform
ISBN 13 : 9781722603083
Total Pages : 138 pages
Book Rating : 4.6/5 (3 download)

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Book Synopsis Patient Protection and Affordable Care ACT - Program Integrity - Exchange, Premium Stabilization Programs, and Market Standards (Us Centers for Medicare and Medicaid Services Regulation) (Cms) (2018 Edition) by : The Law The Law Library

Download or read book Patient Protection and Affordable Care ACT - Program Integrity - Exchange, Premium Stabilization Programs, and Market Standards (Us Centers for Medicare and Medicaid Services Regulation) (Cms) (2018 Edition) written by The Law The Law Library and published by Createspace Independent Publishing Platform. This book was released on 2018-07-05 with total page 138 pages. Available in PDF, EPUB and Kindle. Book excerpt: Patient Protection and Affordable Care Act - Program Integrity - Exchange, Premium Stabilization Programs, and Market Standards (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition) The Law Library presents the complete text of the Patient Protection and Affordable Care Act - Program Integrity - Exchange, Premium Stabilization Programs, and Market Standards (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition). Updated as of May 29, 2018 This final rule implements provisions of the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 (collectively referred to as the Affordable Care Act). Specifically, this final rule outlines financial integrity and oversight standards with respect to Affordable Insurance Exchanges, qualified health plan (QHP) issuers in Federally-facilitated Exchanges (FFEs), and States with regard to the operation of risk adjustment and reinsurance programs. It also establishes additional standards for special enrollment periods, survey vendors that may conduct enrollee satisfaction surveys on behalf of QHP issuers, and issuer participation in an FFE, and makes certain amendments to definitions and standards related to the market reform rules. These standards, which include financial integrity provisions and protections against fraud and abuse, are consistent with Title I of the Affordable Care Act. This final rule also amends and adopts as final interim provisions set forth in the Amendments to the HHS Notice of Benefit and Payment Parameters for 2014 interim final rule, published in the Federal Register on March 11, 2013, related to risk corridors and cost-sharing reduction reconciliation. This book contains: - The complete text of the Patient Protection and Affordable Care Act - Program Integrity - Exchange, Premium Stabilization Programs, and Market Standards (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition) - A table of contents with the page number of each section

Patient Protection and Affordable Care ACT - HHS Notice of Benefit and Payment Parameters for 2014 (Us Department of Health and Human Services Regulation) (Hhs) (2018 Edition)

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Publisher : Createspace Independent Publishing Platform
ISBN 13 : 9781729722640
Total Pages : 268 pages
Book Rating : 4.7/5 (226 download)

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Book Synopsis Patient Protection and Affordable Care ACT - HHS Notice of Benefit and Payment Parameters for 2014 (Us Department of Health and Human Services Regulation) (Hhs) (2018 Edition) by : The Law The Law Library

Download or read book Patient Protection and Affordable Care ACT - HHS Notice of Benefit and Payment Parameters for 2014 (Us Department of Health and Human Services Regulation) (Hhs) (2018 Edition) written by The Law The Law Library and published by Createspace Independent Publishing Platform. This book was released on 2018-11-10 with total page 268 pages. Available in PDF, EPUB and Kindle. Book excerpt: Patient Protection and Affordable Care Act - HHS Notice of Benefit and Payment Parameters for 2014 (US Department of Health and Human Services Regulation) (HHS) (2018 Edition) The Law Library presents the complete text of the Patient Protection and Affordable Care Act - HHS Notice of Benefit and Payment Parameters for 2014 (US Department of Health and Human Services Regulation) (HHS) (2018 Edition). Updated as of May 29, 2018 This final rule provides detail and parameters related to: the risk adjustment, reinsurance, and risk corridors programs; cost-sharing reductions; user fees for Federally-facilitated Exchanges; advance payments of the premium tax credit; the Federally-facilitated Small Business Health Option Program; and the medical loss ratio program. Cost-sharing reductions and advance payments of the premium tax credit, combined with new insurance market reforms, are expected to significantly increase the number of individuals with health insurance coverage, particularly in the individual market. In addition, we expect the premium stabilization programs-risk adjustment, reinsurance, and risk corridors-to protect against the effects of adverse selection. These programs, in combination with the medical loss ratio program and market reforms extending guaranteed availability (also known as guaranteed issue) and prohibiting the use of factors such as health status, medical history, gender, and industry of employment to set premium rates, will help to ensure that every American has access to high-quality, affordable health insurance. This book contains: - The complete text of the Patient Protection and Affordable Care Act - HHS Notice of Benefit and Payment Parameters for 2014 (US Department of Health and Human Services Regulation) (HHS) (2018 Edition) - A table of contents with the page number of each section

Patient Protection and Affordable Care ACT - Amendments to the HHS Notice of Benefit and Payment Parameters for 2014 (Us Centers for Medicare and Medicaid Services Regulation) (Cms) (2018 Edition)

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Publisher : Createspace Independent Publishing Platform
ISBN 13 : 9781722499907
Total Pages : 28 pages
Book Rating : 4.4/5 (999 download)

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Book Synopsis Patient Protection and Affordable Care ACT - Amendments to the HHS Notice of Benefit and Payment Parameters for 2014 (Us Centers for Medicare and Medicaid Services Regulation) (Cms) (2018 Edition) by : The Law The Law Library

Download or read book Patient Protection and Affordable Care ACT - Amendments to the HHS Notice of Benefit and Payment Parameters for 2014 (Us Centers for Medicare and Medicaid Services Regulation) (Cms) (2018 Edition) written by The Law The Law Library and published by Createspace Independent Publishing Platform. This book was released on 2018-07-05 with total page 28 pages. Available in PDF, EPUB and Kindle. Book excerpt: Patient Protection and Affordable Care Act - Amendments to the HHS Notice of Benefit and Payment Parameters for 2014 (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition) The Law Library presents the complete text of the Patient Protection and Affordable Care Act - Amendments to the HHS Notice of Benefit and Payment Parameters for 2014 (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition). Updated as of May 29, 2018 This interim final rule with comment builds upon standards set forth in the HHS Notice of Benefit and Payment Parameters for 2014, published elsewhere in this issue of the Federal Register. This document will adjust risk corridors calculations that would align the calculations with the single risk pool provision, and set standards permitting issuers of qualified health plans the option of using an alternate methodology for calculating the value of cost-sharing reductions provided for the purpose of reconciliation of advance payments of cost-sharing reductions. This book contains: - The complete text of the Patient Protection and Affordable Care Act - Amendments to the HHS Notice of Benefit and Payment Parameters for 2014 (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition) - A table of contents with the page number of each section

Federal Register

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ISBN 13 :
Total Pages : 532 pages
Book Rating : 4.3/5 (121 download)

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Book Synopsis Federal Register by :

Download or read book Federal Register written by and published by . This book was released on 2014-02 with total page 532 pages. Available in PDF, EPUB and Kindle. Book excerpt:

The Affordable Care Act and Medicare in Comparative Context

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Publisher : Cambridge University Press
ISBN 13 : 1316352617
Total Pages : 487 pages
Book Rating : 4.3/5 (163 download)

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Book Synopsis The Affordable Care Act and Medicare in Comparative Context by : Eleanor D. Kinney

Download or read book The Affordable Care Act and Medicare in Comparative Context written by Eleanor D. Kinney and published by Cambridge University Press. This book was released on 2015-07-20 with total page 487 pages. Available in PDF, EPUB and Kindle. Book excerpt: Burdened with perennially rising costs and responsible for providing health insurance to more than one sixth of all Americans, Medicare in its original form is fiscally and demographically unsustainable. In light of dramatic reforms under the Affordable Care Act (ACA), this book provides a comprehensive overview of the current state of Medicare. Eleanor D. Kinney explains how the ACA addresses systemic problems of cost and volume inflation, quality assurance, and fraud. Recognizing the potential for more radical change in the future, Kinney also explores the potential of Medicare to become a single-payer system. Comparisons are made with national health systems in Canada and the United Kingdom, from which the United States can draw valuable lessons. An approachable yet comprehensive account of Medicare and the ACA, this book will be invaluable for health care professionals and informed citizens.

Registries for Evaluating Patient Outcomes

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Publisher : Government Printing Office
ISBN 13 : 1587634333
Total Pages : 396 pages
Book Rating : 4.5/5 (876 download)

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Book Synopsis Registries for Evaluating Patient Outcomes by : Agency for Healthcare Research and Quality/AHRQ

Download or read book Registries for Evaluating Patient Outcomes written by Agency for Healthcare Research and Quality/AHRQ and published by Government Printing Office. This book was released on 2014-04-01 with total page 396 pages. Available in PDF, EPUB and Kindle. Book excerpt: This User’s Guide is intended to support the design, implementation, analysis, interpretation, and quality evaluation of registries created to increase understanding of patient outcomes. For the purposes of this guide, a patient registry is an organized system that uses observational study methods to collect uniform data (clinical and other) to evaluate specified outcomes for a population defined by a particular disease, condition, or exposure, and that serves one or more predetermined scientific, clinical, or policy purposes. A registry database is a file (or files) derived from the registry. Although registries can serve many purposes, this guide focuses on registries created for one or more of the following purposes: to describe the natural history of disease, to determine clinical effectiveness or cost-effectiveness of health care products and services, to measure or monitor safety and harm, and/or to measure quality of care. Registries are classified according to how their populations are defined. For example, product registries include patients who have been exposed to biopharmaceutical products or medical devices. Health services registries consist of patients who have had a common procedure, clinical encounter, or hospitalization. Disease or condition registries are defined by patients having the same diagnosis, such as cystic fibrosis or heart failure. The User’s Guide was created by researchers affiliated with AHRQ’s Effective Health Care Program, particularly those who participated in AHRQ’s DEcIDE (Developing Evidence to Inform Decisions About Effectiveness) program. Chapters were subject to multiple internal and external independent reviews.

Patient Protection and Affordable Care Act; Program Integrity; Exchange, SHOP, Premium Stabilization Programs, and Market Standards

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Publisher :
ISBN 13 :
Total Pages : 64 pages
Book Rating : 4.:/5 (854 download)

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Book Synopsis Patient Protection and Affordable Care Act; Program Integrity; Exchange, SHOP, Premium Stabilization Programs, and Market Standards by : Wolters Kluwer Law & Business (Firm)

Download or read book Patient Protection and Affordable Care Act; Program Integrity; Exchange, SHOP, Premium Stabilization Programs, and Market Standards written by Wolters Kluwer Law & Business (Firm) and published by . This book was released on 2013 with total page 64 pages. Available in PDF, EPUB and Kindle. Book excerpt:

2010 ADA Standards for Accessible Design

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Publisher : Createspace Independent Publishing Platform
ISBN 13 : 9781500783945
Total Pages : 0 pages
Book Rating : 4.7/5 (839 download)

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Book Synopsis 2010 ADA Standards for Accessible Design by : Department Justice

Download or read book 2010 ADA Standards for Accessible Design written by Department Justice and published by Createspace Independent Publishing Platform. This book was released on 2014-10-09 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: (a) Design and construction. (1) Each facility or part of a facility constructed by, on behalf of, or for the use of a public entity shall be designed and constructed in such manner that the facility or part of the facility is readily accessible to and usable by individuals with disabilities, if the construction was commenced after January 26, 1992. (2) Exception for structural impracticability. (i) Full compliance with the requirements of this section is not required where a public entity can demonstrate that it is structurally impracticable to meet the requirements. Full compliance will be considered structurally impracticable only in those rare circumstances when the unique characteristics of terrain prevent the incorporation of accessibility features. (ii) If full compliance with this section would be structurally impracticable, compliance with this section is required to the extent that it is not structurally impracticable. In that case, any portion of the facility that can be made accessible shall be made accessible to the extent that it is not structurally impracticable. (iii) If providing accessibility in conformance with this section to individuals with certain disabilities (e.g., those who use wheelchairs) would be structurally impracticable, accessibility shall nonetheless be ensured to persons with other types of disabilities, (e.g., those who use crutches or who have sight, hearing, or mental impairments) in accordance with this section.

Patient Protection and Affordable Care ACT - Benefit and Payment Parameters for 2015 (Us Department of Health and Human Services Regulation) (Hhs) (2018 Edition)

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Publisher : Createspace Independent Publishing Platform
ISBN 13 : 9781729722411
Total Pages : 198 pages
Book Rating : 4.7/5 (224 download)

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Book Synopsis Patient Protection and Affordable Care ACT - Benefit and Payment Parameters for 2015 (Us Department of Health and Human Services Regulation) (Hhs) (2018 Edition) by : The Law The Law Library

Download or read book Patient Protection and Affordable Care ACT - Benefit and Payment Parameters for 2015 (Us Department of Health and Human Services Regulation) (Hhs) (2018 Edition) written by The Law The Law Library and published by Createspace Independent Publishing Platform. This book was released on 2018-11-10 with total page 198 pages. Available in PDF, EPUB and Kindle. Book excerpt: Patient Protection and Affordable Care Act - Benefit and Payment Parameters for 2015 (US Department of Health and Human Services Regulation) (HHS) (2018 Edition) The Law Library presents the complete text of the Patient Protection and Affordable Care Act - Benefit and Payment Parameters for 2015 (US Department of Health and Human Services Regulation) (HHS) (2018 Edition). Updated as of May 29, 2018 This final rule sets forth payment parameters and oversight provisions related to the risk adjustment, reinsurance, and risk corridors programs; cost sharing parameters and cost-sharing reductions; and user fees for Federally-facilitated Exchanges. It also provides additional standards with respect to composite premiums, privacy and security of personally identifiable information, the annual open enrollment period for 2015, the actuarial value calculator, the annual limitation in cost sharing for stand-alone dental plans, the meaningful difference standard for qualified health plans offered through a Federally-facilitated Exchange, patient safety standards for issuers of qualified health plans, and the Small Business Health Options Program. This book contains: - The complete text of the Patient Protection and Affordable Care Act - Benefit and Payment Parameters for 2015 (US Department of Health and Human Services Regulation) (HHS) (2018 Edition) - A table of contents with the page number of each section

Patient Protection and Affordable Care ACT - Benefit and Payment Parameters for 2018 - Amendments to Special Enrollment Periods (Us Department of Health and Human Services Regulation) (Hhs) (2018 Edition)

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Publisher : Createspace Independent Publishing Platform
ISBN 13 : 9781729722503
Total Pages : 250 pages
Book Rating : 4.7/5 (225 download)

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Book Synopsis Patient Protection and Affordable Care ACT - Benefit and Payment Parameters for 2018 - Amendments to Special Enrollment Periods (Us Department of Health and Human Services Regulation) (Hhs) (2018 Edition) by : The Law The Law Library

Download or read book Patient Protection and Affordable Care ACT - Benefit and Payment Parameters for 2018 - Amendments to Special Enrollment Periods (Us Department of Health and Human Services Regulation) (Hhs) (2018 Edition) written by The Law The Law Library and published by Createspace Independent Publishing Platform. This book was released on 2018-11-10 with total page 250 pages. Available in PDF, EPUB and Kindle. Book excerpt: Patient Protection and Affordable Care Act - Benefit and Payment Parameters for 2018 - Amendments to Special Enrollment Periods (US Department of Health and Human Services Regulation) (HHS) (2018 Edition) The Law Library presents the complete text of the Patient Protection and Affordable Care Act - Benefit and Payment Parameters for 2018 - Amendments to Special Enrollment Periods (US Department of Health and Human Services Regulation) (HHS) (2018 Edition). Updated as of May 29, 2018 This final rule sets forth payment parameters and provisions related to the risk adjustment program; cost-sharing parameters and cost-sharing reductions; and user fees for Federally-facilitated Exchanges and State-based Exchanges on the Federal platform. It also provides additional guidance relating to standardized options; qualified health plans; consumer assistance tools; network adequacy; the Small Business Health Options Programs; stand-alone dental plans; fair health insurance premiums; guaranteed availability and guaranteed renewability; the medical loss ratio program; eligibility and enrollment; appeals; consumer-operated and oriented plans; special enrollment periods; and other related topics. This book contains: - The complete text of the Patient Protection and Affordable Care Act - Benefit and Payment Parameters for 2018 - Amendments to Special Enrollment Periods (US Department of Health and Human Services Regulation) (HHS) (2018 Edition) - A table of contents with the page number of each section

Poised to Profit

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ISBN 13 :
Total Pages : 120 pages
Book Rating : 4.:/5 (319 download)

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Book Synopsis Poised to Profit by : United States. Congress. House. Committee on Oversight and Government Reform. Subcommittee on Economic Growth, Job Creation, and Regulatory Affairs

Download or read book Poised to Profit written by United States. Congress. House. Committee on Oversight and Government Reform. Subcommittee on Economic Growth, Job Creation, and Regulatory Affairs and published by . This book was released on 2014 with total page 120 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Patient Protection and Affordable Care ACT - Benefit and Payment Parameters for 2019 (Us Department of Health and Human Services Regulation) (Hhs) (2018 Edition)

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Publisher : Createspace Independent Publishing Platform
ISBN 13 : 9781729722527
Total Pages : 282 pages
Book Rating : 4.7/5 (225 download)

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Book Synopsis Patient Protection and Affordable Care ACT - Benefit and Payment Parameters for 2019 (Us Department of Health and Human Services Regulation) (Hhs) (2018 Edition) by : The Law The Law Library

Download or read book Patient Protection and Affordable Care ACT - Benefit and Payment Parameters for 2019 (Us Department of Health and Human Services Regulation) (Hhs) (2018 Edition) written by The Law The Law Library and published by Createspace Independent Publishing Platform. This book was released on 2018-11-10 with total page 282 pages. Available in PDF, EPUB and Kindle. Book excerpt: Patient Protection and Affordable Care Act - Benefit and Payment Parameters for 2019 (US Department of Health and Human Services Regulation) (HHS) (2018 Edition) The Law Library presents the complete text of the Patient Protection and Affordable Care Act - Benefit and Payment Parameters for 2019 (US Department of Health and Human Services Regulation) (HHS) (2018 Edition). Updated as of May 29, 2018 This final rule sets forth payment parameters and provisions related to the risk adjustment and risk adjustment data validation programs; cost-sharing parameters; and user fees for Federally-facilitated Exchanges and State Exchanges on the Federal platform. It finalizes changes that provide additional flexibility to States to apply the definition of essential health benefits (EHB) to their markets, enhance the role of States regarding the certification of qualified health plans (QHPs); and provide States with additional flexibility in the operation and establishment of Exchanges, including the Small Business Health Options Program (SHOP) Exchanges. It includes changes to standards related to Exchanges; the required functions of the SHOPs; actuarial value for stand-alone dental plans; the rate review program; the medical loss ratio program; eligibility and enrollment; exemptions; and other related topics. This book contains: - The complete text of the Patient Protection and Affordable Care Act - Benefit and Payment Parameters for 2019 (US Department of Health and Human Services Regulation) (HHS) (2018 Edition) - A table of contents with the page number of each section

Better Regulation Practices across the European Union

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Publisher : OECD Publishing
ISBN 13 : 9264311734
Total Pages : 199 pages
Book Rating : 4.2/5 (643 download)

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Book Synopsis Better Regulation Practices across the European Union by : OECD

Download or read book Better Regulation Practices across the European Union written by OECD and published by OECD Publishing. This book was released on 2019-03-19 with total page 199 pages. Available in PDF, EPUB and Kindle. Book excerpt: Laws and regulations affect the daily lives of businesses and citizens. High-quality laws promote national welfare and growth, while badly designed laws hinder growth, harm the environment and put the health of citizens at risk. This report analyses practices to improve the quality of laws ...

Federal Register Index

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Publisher :
ISBN 13 :
Total Pages : 968 pages
Book Rating : 4.:/5 (319 download)

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Book Synopsis Federal Register Index by :

Download or read book Federal Register Index written by and published by . This book was released on 2010 with total page 968 pages. Available in PDF, EPUB and Kindle. Book excerpt:

What's In, What's Out

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Publisher : Brookings Institution Press
ISBN 13 : 1944691057
Total Pages : 449 pages
Book Rating : 4.9/5 (446 download)

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Book Synopsis What's In, What's Out by : Amanda Glassman

Download or read book What's In, What's Out written by Amanda Glassman and published by Brookings Institution Press. This book was released on 2017-10-10 with total page 449 pages. Available in PDF, EPUB and Kindle. Book excerpt: Vaccinate children against deadly pneumococcal disease, or pay for cardiac patients to undergo lifesaving surgery? Cover the costs of dialysis for kidney patients, or channel the money toward preventing the conditions that lead to renal failure in the first place? Policymakers dealing with the realities of limited health care budgets face tough decisions like these regularly. And for many individuals, their personal health care choices are equally stark: paying for medical treatment could push them into poverty. Many low- and middle-income countries now aspire to universal health coverage, where governments ensure that all people have access to the quality health services they need without risk of impoverishment. But for universal health coverage to become reality, the health services offered must be consistent with the funds available—and this implies tough everyday choices for policymakers that could be the difference between life and death for those affected by any given condition or disease. The situation is particularly acute in low- and middle income countries where public spending on health is on the rise but still extremely low, and where demand for expanded services is growing rapidly. What’s In, What’s Out: Designing Benefits for Universal Health Coverage argues that the creation of an explicit health benefits plan—a defined list of services that are and are not available—is an essential element in creating a sustainable system of universal health coverage. With contributions from leading health economists and policy experts, the book considers the many dimensions of governance, institutions, methods, political economy, and ethics that are needed to decide what’s in and what’s out in a way that is fair, evidence-based, and sustainable over time.